匹兹堡睡眠质量指数在某高校医学生中的信度与效度评价

目的：应用中文版匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）调查某高校医学生的睡眠质量，以评价其在该人群中的信度和效度。方法： 通过分层整群随机抽样方法从北京市某医学院抽取603名本科生，使用中文版PSQI量表和自行编制的问卷进行调查，再随机抽取171名调查对象于1个月后重测，采用多种信度和效度指标对量表进行评价。结果： 调查对象PSQI总分平均为5.38±2.34，量表条目的总体Cronbach’s α系数为0.734，分半信度系数为0.655；重复测量的PSQI总分相关系数为0.530，前后差异无统计学意义（P＞0.05）。在结构效度评价中，验证性因子分析结果表明二因子结构模型为最优模型（拟合优度指数0.949，均方根残差0.083，比较拟合指数0.699），“催眠药物应用”维度因子载荷最低。以患者主观睡眠质量的好、差作为分组效标，PSQI总分的组间差异有统计学意义（P＜0.001），根据PSQI总分绘制的ROC曲线下面积为0.908（95%CI：0.880~0.936）。结论： 该量表用于医学生的睡眠质量评价具有较高的信度与效度，是该人群睡眠研究或筛检的有效工具。

Analysis of the reliability and validity of the Chinese version of Pittsburgh sleep qua-lity index among medical college students

Objective：To evaluate the reliability and validity of the Chinese version of Pittsburgh sleep quality index (PSQI) among the medical students. Methods: A total of 603 undergraduate students were selected from a medical school in Beijing using a stratified-cluster random-sampling strategy, who were assessed by using the Chinese version of PSQI. Then 171 subjects were randomly selected to retest about 1 month later, using a variety of psychometric properties to evaluate reliability and validity of the scale. Results: The average of global PSQI scores was 5.38±2.34, the overall Cronbach’s α coefficient of all the scale items was 0.734, the half-split reliability coefficient was 0.655; the test-retest correlation coefficient was 0.530 for global PSQI score, and there was no statistically significant difference before and after (P＞0.05). As for the construct validity, confirmatory factor analysis results indicated that the two factor model (containing sleep efficiency factor and sleep quality factor) was the optimal model (goodness-of-fit index 0.949, root of the mean square residual 0.083, comparative fit index 0.699), and the factor loading for “hypnotic drug use” was the lowest. Using subjective sleep quality of the students as the criteria, the global PSQI score was statistically different between the criteria-based groups (P＜0.001). And the area under the receiver operating characteristics (ROC) curve which was plotted using the global score of PSQI was 0.908 (95%CI: 0.880-0.936). Conclusion: The Chinese version of PSQI has been verified, having good reliability and validity among the medical students, and is an effective tool to investigate and screen the sleep quality of medical students in China.